I am glad to hear that you are doing so well after getting diagnosed and treated with ADHD (attention deficit hyperactivity disorder). Many of my patients have told me similar stories; recognizing that they are not lazy or stupid have given them hope. They are born with ADHD; it is not because they have done something wrong. Many dropped out of school because they couldn’t pay attention, and have failed repeatedly. Some worked extremely hard and was able to succeed. Their tremendous effort takes a toll on their mental health; they still have poor self esteem. Many smoke or vape nicotine to calm their nerves, or use cannabis and alcohol. There is a high risk of addiction in those with ADHD.

Medications for ADHD, especially long-acting stimulants, can improve attention, reduce distraction, help organization and motivation; they improve executive functions of the brain. I compare taking ADHD medications to wearing glasses. Glasses help the eyes to focus and see clearly; medications help the ADHD brain to focus. That is why you are doing better at work; you don’t have to worry that you may have forgotten to do something important. You can listen to others better.

Homelife also improves with medicine. You may be less frustrated with your children when they argue, or don’t listen. You can complete more tasks and do them better, although you can still forget some appointments. There is less conflict at home. Medicine doesn’t get rid of or fix ADHD, medicine helps you to function better. You and your daughter still have to do the work, but it is a lot easier to get them done.

ADHD medications also help to regulate emotions; you are less frustrated when stressed. They need to be taken daily; on-and-off treatment can cause side effects.

Long-acting stimulants are based on Ritalin and Dexedrine. They have been around for many decades. However, very few adults were treated for ADHD until the last few decades. As a result, there are few reports about their use in pregnant women. Toxicology studies in animals didn’t show any harmful effect on foetuses. Several clinical reviews also showed that ADHD medications are safe during pregnancy.

As you have said, the worry is always there. All mothers want to do the best for their unborn babies, and would do everything to avoid any potential harm. Similarly, doctors usually recommend pregnant women to stop medications that they deem potentially harmful. Because very few adults have been treated with ADHD medications until recently, family physicians and obstetricians are unfamiliar with them, especially their use during pregnancy. Most of the time, they would advice pregnant women to stop them, not knowing how that would impact their lives and their families.

Since ADHD medications have changed your life for the better, stopping them can set you back. It can increase your stress level, and increase stress hormones in the body, which can be harmful to your baby. The increase in conflict at home with your daughters and husband can harm relationship, as well as negatively impacting you at work. All the strategies that you have used before may not be as effective. Sometimes, a small reduction in the dose of medicine may be warranted, instead of stopping it completely.

We know that smoking cigarettes or vaping nicotine can increase ADHD risk in children, probably by unmasking some of the ADHD genes. For those who are dependent on nicotine, it is important to greatly reduce or stop it completely before and during pregnancy. Similarly, alcohol can damage the developing brain; this is called foetal alcohol spectrum disorder, which includes severe ADHD.

If you can avoid smoking and drinking during pregnancy, you are giving your baby the best present already. Stopping ADHD medicine may not be the best option; you should discuss this with your spouse and your doctor. In many communities, there are parenting programs that can offer additional strategies; you may want to consider them in the meantime. These can help you to maintain harmony in your home and reduce overall stress.